The ACP Advocate Blog
by Bob Doherty
Thursday, December 4, 2008
Will the renewed attention to primary care really change things?
Primary care is the flavor of the day. At least, that is what one might conclude from the flurry of articles, blogs, studies and reports that detail the crisis in primary care.
Jason Larkin writes in The Harvard International Review that Senator Tom Daschle, Obama's pick for secretary of Health and Human Services, is intrigued by the idea of creating a "national 'health corps, analogous to the Peace Corps ... [where] doctors finishing their training would be encouraged to do a year or two of domestic service in communities with uneven access to health care professionals.'" Larkin argues, though, that a "health corps should be part of a wider strategy to deal with one of the biggest problems in the American health system: the shortage of primary care physicians" citing ACP's recent white paper.
Paul Testa reflects in the New America Blog on a report by Karen Brown on NPR's All Things Considered about the troubles experienced by 440,000 newly-insured persons in Massachusetts in getting access to primary care doctors.
Victoria Knight writes in the Wall Street Journal Health Blog that it is "lack of access to primary care," not the uninsured, that is clogging up emergency rooms. She suggests that rather than "moving people into the hallways" a better solution is "better incentives for medical students who choose to go into primary care and more pay for physicians who work after hours." (The American College of Emergency Physicians, by the way, takes issue with the idea that "non-urgent" visits to emergency rooms are major factors in ER wait times).
As a good internist might say, awareness that there is a problem is the first step to curing it.
Yet I worry that there still is not the needed sense of urgency among key decision-makers. When I talk to staff on Capitol Hill, they acknowledge the need to do "something" for primary care. But then they add caveats: Where will the money come from? Won't the specialists object? It has to be "politically feasible."
Many don't yet seem to grasp that primary care won't be around much longer unless something big is done now to turn things around. Without a sense of urgency, we could end up with minimalist, non-controversial policies - small steps that are too little, too late, to save primary care.
Today's questions: Do you think your representatives, senators, patients, and neighbors understand the urgency of saving primary care? What are you doing to get them to understand?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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